. . . opponents may never have more power to chart Obamacare’s course than they do right now. In particular, the decisions that federal and state officials make today could determine whether the 2012 elections produce a Congress and president who are willing to repeal the law. In other words, the iron is hot.

Congressional Republicans appear to grasp the weight of this moment. They are doing everything they can to ensure that Obamacare never sees the year 2014: forcing votes on repealing and de-funding the law, and undertaking a two-year campaign to expose its harmful effects. Unfortunately, their efforts are being undercut by their friends back home.

Rather than beat their plowshares into swords, Obamacare opponents in most state capitols are laying the bureaucratic foundations for the law’s new entitlement spending and lending it legitimacy by accepting its debt-financed federal grants.

Running their own exchanges won’t empower states to prevent both the most economical and the most comprehensive health plans from disappearing from their markets. . . .Nor can state-run exchanges prevent other dimensions of quality from eroding. Even in state-run exchanges, the sickest patients would struggle to get their claims paid by insurers who are trying to avoid, mistreat, and dump them, because that is what Obamacare’s price controls reward.

. . .There is no good way, or even a less-bad way, for states or the feds to implement Obamacare’s exchanges or other central elements. Permitted to stand, Obamacare will reduce Americans’ incomes, harm their health, and decrease their freedom